No abstract

The canal of Nuck is analogous to a patent processus vaginalis in a male, which normally loses its communication to the peritoneal cavity within the first year of life. Failure of obliteration of this tract can result in a hydrocele. We present a rare case of a 2-year-old girl with left-sided groin swelling, diagnosed as inguinal hernia. Patient underwent surgical exploration and establishes definitive diagnosis as cyst of the canal of Nuck.

nfantile hemangiomas (IH) are common benign tumors in infancy, affecting 5-10% of all infants and they can still cause disfigurement and serious complications depending on their location and size, which can be associated with ulcerations and haemorrhage. Since 2008, propranolol has become the first choice of therapy for complicated IH, compared to conventional approach with systemic corticosteroid therapy as first-line treatment and then interferon or vincristine as second-or third-line therapeutic agents. We report three cases of hemangioma, successfully treated with propranolol. Oral propranolol was given for a period of 6 months with monthly follow up. All cases showed dramatic response without any relapse after stopping the treatment. Propranolol is novel and safe medication for treatment of infantile hemangioma.

Introduction: Thyroid dysfunction (TD) and diabetes mellitus (DM) are the two most common chronic endocrine disorders with variable prevalence among different populations. Both insulin and thyroid hormones are affected by autoimmune pathology and they do affect cellular metabolism, being a part of the metabolic syndrome. However, the correlations between T2DM and TD have not yet been sufficiently defined, followed by ambivalent results from previous studies.Objectives: The study was conducted to compare the metabolic parameters of patients with T2DM with and those without AITD so as to determine the existence of a correlation between these and hormonal parameters (TSH, FT4).Design and methods: This are documented observational case-control study that included 31 subjects with T2DM and AITD and 25 with T2DM without AITD. Sessions were conducted at the Clinic for Internal Medicine of the University Clinical Center in Tuzla. Individual metabolic parameters were analyzed, and in a broad evaluation, the values of hormonal and immune parameters were monitored and documented.Results: There were no differences in age, gender and BMI of the examined groups. There was a statistically significant difference between the values related to OS, SKT, DKT, PGN, 2h ppPG, and HbA1c. A statistically significant correlation was found between TSH and females, FT4 and BMI (rS = 0.375 pvalue = 0.045) as wellas a correlation between TSH and HbA1c (rS = 0.313 pvalue = 0.019) and TSH and 2x ppPG (rS = 0.281, pvalue = 0.036).Conclusion: The expression of metabolic control parameters is strongest in the group of patients with diabetes and AITD. Their identification as a risk factor and the detection of their subclinical signs are extremely important for the early implementation of preventive and therapeutic strategies, which could change the course of diabetic complications and significantly improve prognosis of diabetes.

Background: Medical nutritional therapy (MNT) is a key component in the treatment of Diabetes mellitus (DM). MNT is completely individual and should be present in the treatment of diabetes from the very beginning, continuously with pharmacological therapy, taking into account lifestyle, dietary habits and the type of antidiabetic therapy. Mistakes that are made when planning the diet are the absence of individual adjustment of the diet, which means that the number and time of meals, as well as the amount of UH per meal, is not adjusted to the patients' oral or insulin therapy according to their pharmacokinetics and pharmacodynamics. Objective: This study investigated the effect of MNT with reduced carbohydrate content (MNT M-ADA) on the efficacy of human and analogue premix insulin in patients with T2DM. Methods: Subjects were randomized into two groups (human and analog premix insulins), and then each group into two subgroups of 30 subjects each. One subgroup each on therapy with human and analog biphasic insulins was educated about MNT and learned to count UH, and then they applied MNT M-ADA for 24 weeks, unlike the other two subgroups. In this review, we present only the subgroup analysis on human and analog premix insulins that applied MNT M-ADA (200 g UH/day). Efficacy outcomes in the analysis of these subgroups were estimated changes in each subgroup from baseline to end point (week 24) and differences between subgroups at the end of the study in levels of glycated hemoglobin (HbA1c), self-measured glucose values (SMBG) and frequency of hypoglycemia. Results: Both subgroups of subjects with MNT M-ADA improved glycemic control, which was assessed by improvements in HBA1C, SMBG levels, without an increase in the frequency of hypoglycemia, but at the end of the study there was no statistically significant difference in the mentioned parameters between the subgroups. Conclusion: The effectiveness of MNT M-ADA in people with T2DM did not depend on the type of insulin, both insulin regimens are effective if the amount of ingested UH is taken into account.